BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

108" .. Patternsof Mortality in Childhood
Rates per 100,000 live births ranged from
102.7 in San Juan Province to 11.8 in Slierbrooke
(Table 50). In an additional 181
deaths- cord conditions were assigned as as-
sociated causes because of their share in
fatal outcome through asphyxia (Table 49).
Congenital anomalies of the umbilical cord
are excluded from this category.
NEONATAL MORTALITY FROM DIFFICULT LABOR AND FROM
BIRTH INJURY WITHOUT MENTION OF CAUSE (764-768, 772)
Included in this group are the different
types of difficult labor due to abnormality
of bones, organs, or tissues of pelvis (764),
with disproportion but no mention of pelvic
abnormality (765), with malposition (766),
with abnormality of forces of labor (767),
and with other and unspecified complications
(768). A fourth digit in each category
is used to specify the type of lesion or effect
on the product, such as lesion to central
nervous system (.0), spinal cord (.1), bone
or nerves (.2), or other unspecified injury
(.3), with asphyxia (.4), and without mention
of injury or anoxia (.9). The group
also includes injury to fetus without mention
of cause (772). Only one type of difficult
labor was assigned to each death as
underlying or associated cause,
Of all neonatal deaths, 1,552 were due to
difficult labor and birth injury as underlying
causes. The rates ranged froi 693.5
per 100,000 live births in San Juan Province
to 93.9 in the California project (Table 51
and Figure 51). In 863 deaths these conditions
were associated causes (Table 52).
Two categories of difficult labor-764
(with abnormality of bones, organs, or
tissues of pelvis) and 765 (with disproportion
but no mention of pelvic abnormality)
-were responsible for 127 neonatal deaths
in all projects. In only 27 additional deaths
were these conditions found to act as associated
causes.
Among all types of difficult labor (764­
768), malposition of fetus (766) produced
the highest death rates in nine projects. The
range was from 291.1 per 100,000 live births
in San Juan Province to 24.6 in the California
project. The explanation for these wide
differences is not available at this moment.
In 408 neonatal deaths in all projects this
group of difficult labor acted as associated
cause.
Categories 767 (with abnormality of
forces of labor) and 768 (with other and
unspecified complications) were underlying
causes in 475 deaths in all projects. The
rates went from 235.4 in San Juan Province
to 17.7 in Sherbrooke. It is I1robable that in
several instances deaths assigned to these
types of difficult birth could have been
assigned to better-defined types if more
d atatec
been available.
Neonatal deaths due to birth injury without
mention of cause (772) were found in
all projects, with rates ranging from 171.1
in Recife to 33.5 in the California project.
Mortality clue to the various types of
difficult labor (764-768) and birth injury
(772) was found to be less frequently associated
with immaturity than the maternal
conditions. As can be seen in Table 51,
50 per cent or more of neenatal deaths from
these causes occurred in immature infants